Concurrent Resolution On The Budget, Fiscal Year 2016
Floor Speech
BREAK IN TRANSCRIPT
Mr. BARRASSO. Madam President, 5 years ago today, President Obama signed his health care bill into law. Since then Americans have watched their paychecks shrink because of the law. Hard-working American taxpayers have paid billions of dollars in higher taxes because of the law. They have had less health care choice because of the law.
So what does the President say about all of this? What does the President say to the millions of Americans who have had to suffer--suffer--through a long list of costly and appalling side effects of the President's health care law? Well, last week he gave a speech in Cleveland and he said, ``It's working even better than I expected.'' He repeated the same thing this weekend, saying, ``It's working even better than I expected.''
Has the President not seen what has happened to workers' paychecks over the last 5 years? Maybe the President missed an article by the Associated Press last Wednesday. The headline was: ``Health care law paperwork costs small businesses thousands.'' The article said, ``Complying with the health care law is costing small businesses thousands of dollars that they didn't have to spend before the new regulations went into effect.''
The article gives the example of Mike Patton, who has a flooring company in the San Francisco Bay area. All of the extra ObamaCare paperwork is costing him about $25,000 a year. To pay for it, the article said, Mike had to ``cut back on workers' bonuses and raises.'' He told the Associated Press, ``They understand it didn't emanate from us ..... They're just disappointed that $25,000 could have gone into a bonus pool.''
Mike Patton's employees will get less money in their paychecks because of all the complex and costly redtape of ObamaCare. Is that even better than the President expected?
People are getting smaller paychecks and they are also paying higher taxes because of this health care law. According to the latest estimate by the Congressional Budget Office, ObamaCare will increase Washington's spending on health care by $1.7 trillion over the next decade. About half of that is for subsidies in the ObamaCare exchanges and about half is to pay for all of the people who have been dumped onto a broken Medicaid system. The $1.7 trillion has to come from somewhere, and a lot of it is coming from hard-working American taxpayers.
ObamaCare included more than 20 tax increases on things such as medical devices, prescription drugs, and even on the very insurance policies that Washington Democrats said everyone has to buy. Why so many taxes? Why is ObamaCare so expensive? Well, an outrageous amount of the money has been wasted over the last 5 years.
Just the other day there was another example that came out of Massachusetts. There was a Boston Herald article last Wednesday, March 18. The headline was: ``Health Connector officials spent $170G on perks.'' The article talks about Federal taxpayer money--Federal taxpayer money--that was given to Massachusetts to set up the State's ObamaCare exchange. The article says:
Massachusetts Health Connector officials behind the state's failed health care website--
Now, remember, the health care Web site in Massachusetts completely failed.
Massachusetts Health Connector officials behind the state's failed health care website have racked up more than $170,000 in taxpayer-funded expenses, including a Boston Harbor summertime boat cruise, luxury hotel stays, ``appreciation'' meals for staffers and contractors--and a $285 Obamacare cake commemorating the launch of the Affordable Care Act. .....
According to the article, ``the Connector's staff and board members scored numerous perks even as they spent hundreds of millions [of dollars] to fix the state portal during its botched Obamacare rollout.''
What does the State have to say about this--about the kind of waste and misuse of taxpayer money? Well, the article actually quotes a spokesman for the exchange saying ``we were happy to do it.'' Does President Obama think that kind of waste is even better than he expected?
It seems as though the American people see headlines like this every day and every day they see more ways the President's health care law has failed us over the last 5 years.
Let me cite one more example, and this one concerns one of the ways ObamaCare has meant less choice for Americans when it comes to their own health care. President Obama promised you could keep your doctor. Millions of Americans over the past 5 years have lost access to their doctor because insurance plans have had to limit the network of doctors those patients can see. That can generate and create real problems for people trying to use their coverage to actually get medical care.
This is about a woman by the name of Pam Durocher from Roseville, CA. An article by Kaiser Health News on February 18 told her story. The headline was: ``Even Insured Consumers Get Hit With Unexpectedly Large Medical Bills.'' And she is insured. The article continued: ``After Pam Durocher was diagnosed with breast cancer, she searched her insurer's website for a participating surgeon to do the reconstructive surgery.'' The article said she did her homework, so ``she was stunned to get a $10,000 bill from the surgeon. `I panicked when I got the bill' ''--no surprise that she panicked when she got the bill--``said the 60-year-old retired civil servant. ..... ''
It turns out the surgeon had two offices and only one of those was in the very narrow network of the insurance plan. The office Pam went to wasn't in the network so she got a bill for $10,000. According to this article: ``Consumer advocates say that the sheer scope of such problems undermine promises''--undermine promises--``made by proponents of the Affordable Care Act that the law would protect against medical bankruptcy.'' It says that, ``Advocates believe a growing number of consumers are vulnerable.''
Let me repeat that: Advocates of the health care law, people who voted for it, believe a growing number--now with the fifth anniversary of the health care law--are vulnerable. And President Obama said that was exactly the type of situation his law was supposed to prevent. Instead, it is exactly the kind of situation his devastating health care law has created.
The Obama administration is bragging--bragging--about the number of people covered by ObamaCare. Is this what those people have to look forward to? Does President Obama really think that making people such as Pam panic means his law is working even better than he expected? It may be better than he expected, but it is a lot worse than what the American people expected. It is also a lot worse than what they were promised.
As a doctor who has practiced medicine for 25 years, I know Americans have always wanted affordable care instead of expensive Washington-mandated coverage. The American people expected health care reform to give them the care they need, from a doctor they choose, at lower cost. Five years ago too many Americans were paying higher premiums. Here we are 5 years later and Americans are paying even higher premiums and finding it harder to see their doctor. This isn't what President Obama promised and it is not what the American people deserve.
In the coming months the Supreme Court will rule on whether the President violated his own law with an unauthorized spending and taxing scheme. This will be a major blow to a law that has failed Americans for more than 5 years and will be an opportunity to finally focus on affordable health care. Republicans are committed to helping the millions of Americans who have been hurt by this law.
We are working on a plan that will deliver freedom, flexibility, and choice to Americans.
Five years later, the law has been bad for patients, it has been bad for providers, and it has been terrible for the American taxpayers. This anniversary today is not a cause for celebration. It is a call for action.
Madam President, I ask unanimous consent to have printed in the Record the following articles from the Boston Herald, the Associated Press, and Kaiser Health News.
There being no objection, the material was ordered to be printed in the RECORD, as follows:
[From the Boston Herald, March 18, 2015]
Health Connector Officials Spent $170G on Perks
(By Chris Cassidy, Erin Smith and Matt Stout)
Massachusetts Health Connector officials behind the state's failed health care website have racked up more than $170,000 in taxpayer-funded expenses, including a Boston Harbor summertime boat cruise, luxury hotel stays, ``appreciation'' meals for staffers and contractors--and a $285 Obamacare cake commemorating the launch of the Affordable Care Act, a Herald review has found.
Under the Patrick administration, the Connector's staff and board members scored numerous perks even as they spent hundreds of millions to fix the state portal during its botched Obamacare rollout. Among them:
$553 for a harbor cruise for an employee celebration in September 2013, part of a $1,495 total expense item that also covered costs for Sam LaGrassa's sandwiches and Lizzy's Ice Cream.
A $236 one-night stay at the Palms Hotel in Miami, which bills itself as a beachside oasis with ``spa-inspired'' bathrooms, an on-site spa and ``impressive views of the ocean,'' plus $944 in stays at Nine Zero and Millennium Bostonian, and $352 at the Omni Parker House.
A $285 Obamacare cake in October 2013, and thousands for employee ``appreciation'' desserts and catered meals for staffers and contractors, including a $236 ``cookie tray'' from Metro Catering, $298 for Lizzy's Homemade Ice Cream, $134 for pastries from Fratelli's Pastry Shop and an unspecified amount from Dandy Donuts for call-center employees in Illinois.
About $20,400 in parking costs that officials say the state's taxpayer-funded Medicaid program will ultimately cover.
All told, Connector officials ran up $171,030 in expenses in the 19 months from July 2013 through January 2015, the review found.
Connector spokesman Jason Lefferts defended the expenses, noting they also include trips to Maryland and Washington, D.C., to meet with Obama administration officials at an important time in the relaunch of the website.
``We found the right path and we got a website that worked,'' said Lefferts. ``In terms of the food and the appreciation, obviously not just for staff here, but for the vendors that worked for us and the navigators that were helpful to us. If we bought them a bagel or a sandwich in appreciation, we were happy to do it.''
From the start, the Connector's Obamacare portal was plagued by embarrassing glitches that, among other things, blocked people with hyphenated last names from signing up for plans, and forced others to falsely claim to be prison inmates or mental patients before they could finish their applications. Others complained about frequent computer crashes and long waits on the phone.
Travel costs for board members to attend meetings also ran high, the review found. Former board member Ian Duncan--a University of California at Santa Barbara professor--was reimbursed $16,584 for travel.
Board member Lou Malzone, who lives on Cape Cod, expensed $11,196 for travel and hotels. Malzone chalked up the costs to times he stays overnight ahead of a board meeting, instead of making the 75-mile, one-way trip to and from the Cape.
``You tell me if you can find (a hotel) for under $200 or $300 a night in Boston,'' Malzone said.
Other larger expense reports, he said--including at least four that topped $1,000--are from times he was out of town on business or vacation and flew back for a board meeting.
``I have a pretty good attendance record,'' he said, estimating he's missed just four meetings over nine years. ``If you're out of town and there's a business meeting, I go back, rather than do conference calls.''
--
[From the Associated Press, March 18, 2015]
Health Care Law Paperwork Costs Small Businesses Thousands
(By Joyce M. Rosenberg)
New York.--Complying with the health care law is costing small businesses thousands of dollars that they didn't have to spend before the new regulations went into effect.
Brad Mete estimates his staffing company, Affinity Resources, will spend $100,000 this year on record-keeping and filing documents with the government. He's hired two extra staffers and is spending more on services from its human resources provider.
The Affordable Care Act, which as of next Jan. 1 applies to all companies with 50 or more workers, requires owners to track staffers' hours, absences and how much they spend on health insurance. Many small businesses don't have the human resources departments or computer systems that large companies have, making it harder to handle the paperwork. On average, complying with the law costs small businesses more than $15,000 a year, according to a survey released a year ago by the National Small Business Association.
``It's a horrible hassle,'' says Mete, managing partner of the Miami-based company.
But there are some winners. Some companies are hiring people to take on the extra work and human resources providers and some software developers are experiencing a bump in business.
Companies must track workers' hours according to rules created by the IRS to determine whether a business is required to offer health insurance to workers averaging 30 hours a week, and their dependents. Companies may be penalized if they're subject to the law and don't offer insurance.
Businesses must also track the months an employee is covered by insurance, and the cost of premiums so the government can decide if the coverage is affordable under the law.
Many companies have separate software for payroll, attendance and benefits management and no easy way to combine data from all of them, says John Haslinger, a vice president at ADP Benefits Outsourcing Consulting. And early next year, employers must complete IRS forms using information from these different sources. The process is more complex for businesses with operations in different states.
Mike Patton's health insurance broker is handling the extra administrative chores for his San Francisco Bay-area flooring company DSB Plus, but he's paying for it through higher premiums--about $25,000 a year.
To pay for the extra services the business is getting from his broker, Patton cut back on workers' bonuses and raises.
``They understand it didn't emanate from us,'' Patton says. ``They're just disappointed that $25,000 could have gone into a bonus pool.''
That kind of spending has led to a surge in business for payroll providers, human resources consultants and health insurance brokers that track hours and keep records for small businesses, and even file documents with the government.
Sales have more than doubled in the last year at human resources provider Engage PEO. Many of its clients are small companies.
``They want to comply with the law and don't want to be subject to an unintended penalty,'' says Dorothy Miraglia King, executive vice president of the St. Petersburg, Florida-based company.
Businessolver, a company whose primary business is creating software to help companies administer benefits, also reports an uptick in demand. In 2013, when clients started becoming aware of the law's paperwork requirements, they asked for software that could take care of all their needs, says Rae Shanahan, a human resources executive at the West Des Moines, Iowa, company.
``The traditional systems that people have can't handle it,'' she says.
--
[From Kaiser Health News, Feb. 18, 2015]
Even Insured Consumers Get Hit With Unexpectedly Large Medical Bills
(By Julie Appleby)
After Pam Durocher was diagnosed with breast cancer, she searched her insurer's website for a participating surgeon to do the reconstructive surgery.
Having done her homework, she was stunned to get a $10,000 bill from the surgeon.
``I panicked when I got that bill,'' said the 60-year-old retired civil servant who lives near Roseville, Calif.
Like Durocher, many consumers who take pains to research which doctors and hospitals participate in their plans can still end up with huge bills.
Sometimes, that's because they got incorrect or incomplete information from their insurer or health-care provider. Sometimes, it's because a physician has multiple offices, and not all are in network, as in Durocher's case. Sometimes, it's because a participating hospital relies on out-of-network doctors, including emergency room physicians, anesthesiologists and radiologists.
Consumer advocates say the sheer scope of such problems undermine promises made by proponents of the Affordable Care Act that the law would protect against medical bankruptcy.
``It's not fair and probably not legal that consumers be left holding the bag when an out-of-network doctor treats them,'' said Timothy Jost, a law professor at Washington and Lee University. Jost said it's a different matter if a consumer knowingly chooses an out-of-network doctor.
Durocher learned only after getting her surgeon's bill that just one of his two offices participated in her plan and she had chosen the wrong one. She said the doctor's staff later insisted that they had raised the issue during her initial consultation, but she doesn't recall that, possibly because she was distracted by her cancer diagnosis.
Adding insult to injury, insurers are not required to count out-of-network charges toward the federal health law's annual limit on how much of their medical costs patients can be asked to pay out of their own pockets.
Efforts by doctors, hospitals and other health providers to charge patients for bills not covered by their insurers are called ``balance billing.'' The problem pre-dates the federal health law and has long been among the top complaints filed with state insurance regulators.
Because the issue is complex and pits powerful rivals against one another--among them, hospitals, doctors and insurers--relatively few states have addressed it. What laws do exist are generally limited to specific situations, such as emergency room care, or certain types of insurance plans, such as HMOs.
The federal health law largely sidesteps the issue as well. It says insurers must include coverage for emergency care and not charge policyholders higher copayments for ER services at non-network hospitals, because patients can't always choose where they go. While the insurer will pay a portion of the bill, in such cases, doctors or hospitals may still bill patients for the difference between that payment and their own charges.
That means that in spite of having insurance, a consumer involved in a car wreck and taken to a non-network hospital might receive additional bills, not just from the hospital, but from the radiologist who read his X-rays, the surgeon who repaired his broken leg and the laboratory that processed his blood tests.
NETWORKS GET NARROWER
Advocates believe a growing number of consumers are vulnerable to balance billing as insurance networks grow smaller in the bid to hold down costs.
For example, there were no in-network emergency room physicians or anesthesiologists in some of the hospitals participating in plans offered by three large insurers in Texas in 2013 and 2014, according to a survey of state data by the Center for Public Policy Priorities, a Texas advocacy group.
Smaller networks are also becoming more common in employer-based insurance: About 23 percent of job-based plans had so-called ``narrow networks'' in 2012, up from 15 percent in 2007, according to a May report from the Urban Institute and Georgetown University Center on Health Insurance Reforms.
To protect consumers, advocacy groups, including Consumers Union and the American Cancer Society Cancer Action Network, want regulators to strictly limit balance billing when an insured person gets care in a medical facility that is part of an insurer's network.
``Without protection from balance billing, the cost of out-of-network care can be overwhelming,'' wrote Consumers Union in a recent letter to the National Association of Insurance Commissioners (NAIC), which is updating a model law that states could adopt to regulate insurance networks.
NAIC'S current draft does not directly address the issue of balance billing and consumer efforts have drawn sharp opposition from insurers, hospitals and doctors.
Some states have taken other steps to protect consumers:
Earlier this month, California set out new rules requiring some insurers to provide accurate lists of medical providers in their networks.
New Jersey specifies that insurers guarantee that certain providers be available ``within 20 miles or 30 minutes average driving time.''
Colorado insurers must pay non-network medical providers their full charges, not discounted network rates, for care at in-network hospitals.
In Maryland, insurers must pay for ``covered services,'' which includes emergency care, but the state sets standardized payment rates.
Starting in April, New Yorkers won't face extra bills for out-of-network emergency care, when an in-network provider is unavailable or when they aren't told ahead of time that they may be treated by a non-participating provider. Instead, the bills must be settled in arbitration between the providers and the insurance companies.
COST TRADE-OFFS
Insurers defend the move to smaller networks of doctors and hospitals as a way to provide the low-cost plans that consumers say they want. Since insurers can no longer reject enrollees with health problems or charge them more, the plans are using the tools left to them to reduce costs.
If regulators required them to fully cover charges by out-of-network doctors, that could reduce ``incentives for providers to participate in networks'' and make it harder to have adequate networks, America's Health Insurance Plans, the insurers' trade group, and the Blue Cross Blue Shield Association wrote in a joint letter to the NAIC.
It would also raise premiums.
Instead, AHIP says, states could require out-of-network doctors to accept a benchmark payment from insurers, perhaps what Medicare pays, rather than balance billing patients.
Physicians, meanwhile, blame insurers for inadequate networks.
``It is the limited coverage, not the physician bill, which is the cause of the unfairness,'' the Texas Medical Association wrote to the NAIC.
At the very least, doctors and hospitals say insurers need to do a better job of educating policyholders that their plans may not cover care provided by some doctors and hospitals.
``There's no `free' anywhere,'' said Lee Spangler, vice president of medical economics with the Texas Medical Association. ``You either pay for the coverage through premiums, or you pay for service when you receive it.''
Doctors choose whether to balance bill, he added--and some don't.
But he noted that patients ``have received professional services in the expectation that they will get alleviation of what ailed them, and the physicians provided it in the expectation they would be paid. There's no in between,'' Spangler said.
For patients like Durocher, who got billed even after doing everything she was told, the only recourse is to negotiate with the physician or hospital to ask them to lower or drop the charges.
``Fortunately for me,'' Durocher said, ``this doctor was very nice and wrote off almost $7,000 of the bill.''
Mr. BARRASSO. Madam President, I yield the floor.
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